Skip to Accessibility Tools Skip to Content Skip to Footer

Opioids, Long-term Chronic Pain, and Quality of Life

I hear about and read references to “quality of life” often when the subject of rheumatoid disease and other diseases that cause chronic pain come up.

A few days ago, one such reference stopped me. It was in a Washington Post article, “Opioid Drugs Make Pain Tolerable, Most Long-Term Users Say.” The article cited a recent poll that found that many people with long-term chronic pain believe that opioid pain relievers work for them. These patients believe these drugs, the article stated, improve their “quality of life.”

The article contrasted that belief with the CDC’s March 2016 Opioid Prescribing Guideline for Primary Care Physicians, which states that they don’t consider opioid analgesics effective for long-term chronic pain—even though they admit that research into their use for that reason is “limited.”

If you’ve taken these drugs for the chronic, unpredictable, and often severe joint pain that is a major symptom of rheumatoid disease, and you haven’t experienced any unpleasant side-effects that might prevent you from taking them again, you’ve probably noticed that while they usually don’t erase the pain, they do blunt it to a great degree.

A blogger friend of mine uses music as a terrific analogy about the way opioids work for her when she’s flaring: If you have your music (your pain) turned up high, you pretty much can’t ignore it. That music is now front and center in your life. But if you turn it way down (take an opioid pain reliever), the music (pain) goes into the “background.” You can still hear (feel) it, but most of the time, it’s low enough that you can mostly ignore it. You can concentrate on other things.

For many of us, turning down the volume on our pain can make all the difference between having a decent “quality of life” and—to put it bluntly—suffering through a poor one.

But what is “quality of life?” It’s a concept that’s fairly vague, and it can change in subtle ways depending on context. I did some googling on the subject, though, and I think the World Health Organization’s definition is the best. It takes each individual’s circumstances into consideration and honors their own perception of the concept.

WHO defines “quality of life” as the individual’s “perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.”

The Merriam-Webster Online Dictionary puts it more simply. “Quality of life” can be “How good or bad a person’s life is.”

Having so recently discovered just how much my own “quality of life” changed for the worse when my primary care doctor denied my opioid analgesics, my reaction to the Washington Post’s article was, first, “well, duh!”

And then it made me grateful. Finally, after months of negative press regarding opioids because of the U.S. government’s sudden, negative, clumsy, all-out response to the “opioid crisis,” an article comes out that give a voice to legitimate patients who use these drugs responsibly to treat long-term chronic pain. It shows that opioids can and do work for long-term chronic pain. They can and do improve these patients’ “quality of life.”

How could the CDC reasonably think otherwise?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Measuring Quality of Life: The World Health Organization Quality of Life Instruments. (1997) World Health Organization. Retrieved on Dec. 20 from http://www.who.int/mental_health/media/68.pdf
  2. Guskin, E. (2016, Dec. 20) Opioid Drugs Make Pain Tolerable, Most Long-Term Users Say. Washington Post. Retrieved on December 20, 2016.

Comments

  • Connie Rifenburg
    2 years ago

    Thank you Wren for your views. I cringe every time I hear you refer to your dr. who took the opioid away from you. I know I don’t know you personally, but from your writings, it can not be possible that you are so addicted to this drug that you need to have it removed from you treatment! If possible, is there another dr. that can treat you that has a different opinion on the use of opioids for long term chronic pain? I hope so for your sake.

    I resisted as long as I could before my “quality of life” was so compromised by my pain that the choice was to take oxycodone or stay in bed, in pain. I have now been on the same amount of oxycodone as I was started on 3 years ago. I take one in the AM and one before bed. I’m not tempted to take more. I’m not taking it to feel a ‘high’, I take it for the relief it gives…good analogy of the loud music!!

    But, I have had such a hard time while in the ER or hospitalized dealing with my oxycodone. Am I addicted? Yes. Not in the way that most people think of it where I am drug seeking. But I would begin to go through withdrawal after about 6 hrs. That’s a fact I have to live with.

    My dose is perfect for controlling my pain. That’s all I need, but when I was recently in the hospital and in much pain – high fever of unknown origin, the doctor on call decided to stop all my meds. That included 30mg of prednisone , oxycodone, prozac, protonix, aldactone, and then the 81mg aspirin for my tia’s and pramipexol for restless legs.

    Let me tell you, I was so sick for 3 days while they let me suffer and scream and act like a crazy person because they had removed ALL my meds (only one of which was an opioid!!) I went thru dry heaves, vomiting, uncontrolled restlessness until finally a member of my family came in and demanded that they contact my RA dr. and give me at least the steroid (since the withdrawals were making me crazy) in addition to running a 104 degree temp.

    It was the hospital dr. that didn’t want to give me the oxy who told the nurses to slow down my dose … meaning they would not come in the room to give me my meds on a timely manner even after my doctor ok’d it. It was truly cruel.

    It was finally resolved when I went into sepsis the 3rd night and they had to pack me in ice trying to bring down the temp. Because of that, the next morning, 6 drs appeared at my bedside after reading the nurses’ report. They finally contacted my RA dr, she visited and told them to give me 150 mg of prednisone IV, and they should never have stopped it and she told them I didn’t abuse the Oxy and that I needed it on a regular basis since I had been on it for 3 yrs.

    By the 4th day, after getting antibiotics IV, all my meds, and that huge boost of steroids, I was a human being again. When the nurses and dr. came in to see me, they acted so surprised that I was acting normal again. I told them that they had
    caused the reactions by removing all my meds suddenly when I had been on most of them for 10-15 yrs and the oxy for 3 yrs.

    One nurse came to me before I left the hospital and gave me instructions on who to contact at the hospital to report what had happened. She was the only nurse who took the time to treat me as a whole person. The excuse of the hospital was that I presented with a high fever and that was what they were treating. Too bad about the other meds I needed for my chronic disease.

    What has happened to the medical community when they see a person using opioids is that they automatically decide that they are an addict and won’t treat any symptoms that are not related to the reason you were admitted. None of my doctors even go to the hospital anymore, but my RA came because my family had called and told her what was going on.

    Hospitals have their own drs. to treat ALL the patients and they know nothing of my background, yet made decisions that made me worse. One dr. apologized (the infectious disease dr) who said that they should not have taken the meds away especially since I had been on steroids for 15 yrs and I was already in a flare that had caused me to go up to 30mg/day and for 3 days they cut it to ZERO. He saw me before I was given the IV and I couldn’t even carry on a conversation with him. The day after they got me back on my meds, he came in and said, you look like a different person. How sad it was that I had to go thru this because the Gov’t has decided that “we” don’t need opioids and has put the fear of giving them in the doctors!!

    I hate to mention to any of my new dr. or any ER that I am taking oxycodone because of the way they treat me due to this. I wouldn’t have believe it, if I hadn’t experienced it myself.

    It was a family advocate that stepped in to call a dr. that knew me and it was her coming to the hospital that changed the way I was treated, but I think of all the other patients who might have suffered like I did, but have no advocate to speak for them.

    And btw, I was there 6 days with 104 degree temp, and when they finally brought it down to 101, they sent me home with the diagnosis of “fever of unknown origin”.

    I guess the moral of my story is be careful who you tell that you take an opioid.

  • Carla Kienast
    2 years ago

    Hi Wren: Thank you again for such a direct and personal look into responsible use of opioid medications for those in chronic pain who need them for, as you say, the basic level of quality of life. An excellent article pointing out the FDA’s reversal of their previous concerns that pain had been inadequately treated appears in the Orange County Register: http://www.ocregister.com/articles/pain-709555-cdc-chronic.html

  • Lawrence 'rick' Phillips
    2 years ago

    Wren, I am happy that I seldom have to use opioids, but I also know exactly how bad it can be. I have been in the supermarket unable to move because of pain and using opioids.

    If a person has ever needed opioids and received them, it is a God send. I cannot imagine someone being denied the medication that needs them.

  • Angela Lundberg
    2 years ago

    Excellent and much-needed article, Wren! Thank you for writing it. And the pain-opioid analogy you describe is very accurate! People who are unnecessarily “freaking out” about the “opioid crisis” need to read the Washington Post’s article as well as yours. 🙂

  • Poll